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Longevity of band and loop space maintainers using glass ionomer cement: a prospective study
I S Sasa1, A A Hasan, M A Qudeimat
1Dept of Paediatric Dentistry, University of Texas Health Science Center, San Antonio, TX, USA.
Insights
Band and loop space maintainers showed a high failure rate (57.5%), primarily due to decementation. While the median survival time was acceptable, further research is needed to compare cements.
Area of Science:
- Pediatric Dentistry
- Biomaterials Science
Background:
- Space maintainers are crucial in pediatric dentistry to preserve arch length after premature tooth loss.
- Glass ionomer cements are commonly used for luting dental appliances, but their long-term efficacy requires evaluation.
Purpose of the Study:
- To prospectively evaluate the success rate and median survival time of band and loop space maintainers.
- To identify factors influencing the failure of these appliances when luted with glass ionomer cement.
Main Methods:
- A prospective study involving 40 children aged 3.4-7.3 years, each receiving one band and loop space maintainer.
- Standardized procedures for appliance fabrication and cementation using Ketac-Cem-Maxicap glass ionomer luting cement.
- Follow-up appointments at 4-6 month intervals, with survival time analysis using Log-Rank and Chi-square tests.
Main Results:
- A high failure rate of 57.5% was observed over a 40-month study period.
- Decementation accounted for 82% of all failures, highlighting issues with band attachment.
- Appliances on the left side of the mouth demonstrated a statistically significant higher survival rate (p<0.008) compared to the right side.
Conclusions:
- Despite a clinically acceptable median survival time of 19.9 months, the overall failure rate of band and loop space maintainers was high.
- Decementation of the band is the primary cause of failure, necessitating improved luting strategies.
- Further comparative studies are recommended to assess newer resin-modified luting cements against traditional glass ionomer cements.
Aim:
This was to prospectively investigate the success and median survival rate of band and loop space maintainers using glass ionomer luting cement for attachment.
Methods:
A total of 40 children (22 females and 18 males) between the ages of 3.4 and 7.3 years participated in the study. Each patient received only one band and loop space maintainer. For each child, the same paediatric dentist carried out all diagnosis, band selection, and impression taking and appliance cementation. The same dental technician fabricated all appliances. The luting cement used was Ketac-Cem-Maxicap. Regular follow up appointments were scheduled at 4-6 months intervals. Variables, which might have affected the median survival time for the appliances were tested using Log-Rank and Chi-square tests.
Results:
40% of the band and loop space maintainers were successful and 57.5% failed during the study period (40 months). The most common cause of failure was decementation (82% of all failed cases). The overall median survival time was 19.9 months. Appliances fitted in the maxillary and mandibular left side of the mouth showed a statistically higher survival rate than those fitted in the right side (maxillary left quadrant = 35 months, mandibular left quadrant = 28 months, maxillary right quadrant = 14 months, mandibular right quadrant = 16 months) (p<0.008).
Conclusions:
Although the overall median survival time was clinically acceptable (19.9 months), the failure rate of the band and loop space maintainers in general was high (57.5%). The main reason for failure was decementation of the band. Further studies are required to compare glass ionomer cements with more recent resin modified luting cements.